The survival rate for prostate cancer is steadily improving, with the current 10-year survival rate is 98%. This is in large part due to better early detection, but also may be due to better surgical intervention. However, about 6-8% of men who have prostate surgery experience urinary incontinence, or leakage, after surgery.
Dr. Paul H. Chung is an experienced specialist with a deep understanding of male urinary incontinence. He can help you understand why you’re having this uncomfortable problem, as well as suggest effective treatment strategies so that you don’t have to continue to live with it.
Why prostate surgery causes incontinence
Your bladder stores urine until your brain signals it’s time to release it. The urethra is a tube that transports urine from your bladder to the outside of your body. There are two valves, called sphincters, on your urethra that open to release urine.
Your prostate gland surrounds your urethra and is located near one of those sphincters, and when you have your prostate removed, one of your sphincters is removed as well. Most of the time, having one functioning valve to hold in or release urine may be sufficient, but in some cases the nerves and muscles in the area are affected and urinary incontinence is the result. Prostate removal surgery may include complete removal for cancer or partial removal to treat an enlarged prostate.
Different types of urinary incontinence
There are several different types of urinary incontinence, but the most common in men who have had prostate surgery is called stress incontinence. When you cough or sneeze, or pick up something heavy, the muscles in your abdomen put extra pressure on your bladder and urine may leak out.
You may have just a few dribbles of urine, a medium amount, or even a heavy loss of urine. You may find that you have a higher degree of incontinence right after surgery, and that it gets better with time. If you continue to have issues, though, there are treatments.
How long does incontinence last?
One thing you should know is that most men regain continence following prostate surgery. If you’re between the ages of 40 and 60, and generally healthy, the outlook is particularly good. In such cases, most men are no longer experiencing incontinence after about three months.
For others, it takes closer to a year. In such cases, there are effective treatments.
Treating urinary incontinence
Since stress incontinence is a problem caused by the structure of your urinary tract, medication isn’t generally a successful approach. Most patients with urinary incontinence use multiple pads or pull ups each and every day to catch the leaked urine. Although the pads and pull ups may help, they often result in an odor, cause irritation to the skin, and are costly in the long run.
Other patients may elect to use a penile clamp which is a foam clamp applied to the shaft of the penis to squeeze on the urinary tube and prevent leakage. Although the clamp may help, it is uncomfortable and can typically only be worn for a few hours at a time.
Dr. Chung usually begins treatment by addressing lifestyle factors and encourages patients to work with physical therapy to strengthen the pelvic floor muscles. Although physical therapy may help, it often does not cure leakage completely.
If those don’t correct the issue, you may need surgical intervention. There are two main ways to address urinary incontinence with surgery. The first is using a urethral sling, which repositions your urethra and slightly compresses it.
The second surgery is an artificial urinary sphincter. This is a device that includes a small cuff around your urethra, a pump in the skin of your scrotum, and a balloon in your abdomen. When you need to urinate, you gently squeeze the pump, which opens the cuff and allows the urine to pass through your urethra.
Why would someone choose surgery to treat incontinence?
Urinary incontinence is one of the most bothersome symptoms after prostate surgery. When people suffer from incontinence, they may become depressed, may no longer participate in daily activities that they used to, and may even be reluctant to spend time with friends due to potentially being embarrassed after an accident. Surgery with a urethral sling or artificial urinary sphincter is an excellent option because they can change lives and restore function.
If you’ve had prostate surgery and found that you’re experiencing urinary incontinence, schedule an appointment with Dr. Chung. He can evaluate your situation and suggest a treatment plan for you.